NPI | 1487085833 |
---|---|
Entity Type | Organization |
Authorized Contact | MICKEY EDSON GORDON Owner 239-566-8800 |
Organization Subpart ? | Yes |
Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: FL PO0002638) |
Enumeration Date | 2013-12-11 |
Last Update Date | 2013-12-11 |